Tucson Medicare Advantage Changes

Big changes are coming to Tucson Medicare Advantage plans in 2015. People enrolled in Tucson Medicare Advantage plans will be getting the news very soon.

Agents are not supposed to talk about 2015 “benefits” until October 1st, but what about “changes”? Here are some of the changes coming to Tucson Medicare Advantage plans:

The plan with the largest enrollment (over 20,000) will have a deductible in its drug plan.

A $0 premium plan will have a $39 premium in 2015 and a deductible in its drug plan.

One company is dropping the University of Arizona Medical Center from its network, at least for its $0 premium plan.

One company is dropping three plans and keeping just one (in Pima County).

That same company is losing Arizona Community Physicians from its network.

A well-known company will enter the Tucson Medicare Advantage market for 2015.

Sorry, but I can’t name names at this point. I think about half of my Medicare Advantage clients will be affected by these changes. Brokers are going to be very busy helping their clients figure out if they need to change their Advantage plan or if they can stay put.

Open Enrollment Period: October 15 – December 7

If your Medicare Advantage plan is changing for 2015 and you want to move to another plan you must:

Make sure your doctors are in that plan’s network (if you want to keep all your doctors)

Make sure your prescriptions are covered by the new plan you are considering and find out what your co-pays will be.

Fill out an application for the new plan between October 15 and December 7th. Your new plan would begin on January 1, 2015.

People in Tucson currently have seventeen Medicare Advantage plans to choose from. That number will be reduced for 2015, but there will still be many choices. Some plans have bigger networks, but higher co-pays for services. Some plans have lower co-pays for doctor visits and hospital stays, but smaller networks. Most plans have a $45 co-pay for insulin while one plan charges $10 and another $0. (This last plan has a small network.)

Annual Notice of Change (ANOC)

Changes to your Tucson Medicare Advantage plan are announced in the Annual Notice of Change, which is in the mail right now. I’ve heard some people have already received their ANOC. The important information is not exactly highlighted and must be found on about the fifth page of a 30-page document. (I haven’t seen an ANOC this year, so I’m describing what I’ve seen in the past.) The key point here is that everyone needs to read their ANOC thoroughly, from start to finish.

I think the network changes will be announced in letters to people who are affected. Saddlebrooke residents will be getting letters. People with a primary care doctor who is with Arizona Community Physicians or University Physicians will be getting letters telling them they can no longer see those doctors if they remain in their plan – depending on the Medicare Advantage plan they have.

Most of the Tucson Medicare Advantage plans will have seminars to promote their plans, but to compare plans you’d have to attend five or six seminars. Pima Council on Aging offers seminars that talk about Medicare Advantage and Medicare supplements in general terms, but they don’t tell you about specific plans.

An insurance broker who represents all the plans in Tucson can compare them side-by-side for you. The broker can also tell you about each plan’s network and can check to see if your doctors are in the network. If you are talking to a broker, ask her how many plans she represents and why she represents them. It’s up to you to decide if you are going to make a change. A broker should not pressure you to make a decision on the spot. The broker should tell you she will be available in the future to help you with any questions or issues you might have with your Medicare Advantage plan.

I know I’m promoting brokers (and I am a broker), but most brokers really do care about their clients. I know there are some bad brokers out there, but the ones I know are advocates for their clients and know all the plans. With all the changes coming to Tucson Medicare Advantage plans, people are going to need an advocate. I need to make sure my clients know that their plan is changing or their provider network is changing. I’m going to be very busy for the next two months.

Denise

Denise Early is an independent insurance broker in Tucson, Arizona. She is interested in policy and the politics of Medicare. She enjoys telling the stories of people she meets and sees herself as an advocate for her clients. She served in the Peace Corps and has a Masters degree in International Management.

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Medicareblog.org is not affiliated with Medicare or Social Security. Posts on this blog are meant to provide information and insight into many aspects of Medicare. Denise s a licensed insurance agent in Arizona.